NURS549 Final Exam Study Guide Solutions

NURS549 Final Exam Study Guide Solutions 2 Monoclonal immunosuppressive Antibody Drugs - Ans:-Daclizumab(zenapax)- Reduces activated T- cell numbers and activities by binding to interlukin Muromonab(orthoclone)-Binds to CD3 receptors on T cells and disrupts function. Depletes circulating T cells Monoclonal Antibody drug MOA - Ans:-Clinical application is in TARGETING T-CELLS AS ANTIGENS, tagging them for attack, disrupting T-Cell ( Cell Mediated Immunity ) function and ultimately providing immunosuppression Cloned from Bcells used for transplant rejection 2 antimetabolite drugs for immunosupressant - Ans:-Azothioprine ( Imuran)- Purine analog LYMPHOCYTES ( T-CELLS & B-CELLS) ARE PREDOMINATELY AFFECTED BY THE CYTOTOXIC EFFECTS OF AZATHIOPRINE.!!!!!!! , and this gives immunosupression ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 2/53 Mycophenolate ( Cellcept)- It inhibits the enzyme ( inosine monophosphate dehydrogenase) that controls the rate of synthesis of the nucleotide ..Guanine MonoPhosphate (GMP) Antimetabolite MOA - Ans:-( Purine Analogues) are drugs that mimic the structure of metabolic purines, and do not allow synthesis of DNA. T-Cells and B-Cells, are rapidly proliferating cells and are cells that are particularly affected by the inhibition of purine synthesis. T-Cell and B-Cell production is inhibited and Immunosuppression is accomplished.!!!!!! generally used in combination with corticosteroids and the Inhibitors of Cytokine Production 2 Selective Cytokine production inhibitors - Ans:-Cyclosporine ( Neoral, Sandimmune)-Cyclosporine complex that binds to the calcineurin does not allow the normal dephosphorylating of the NFATs to occur, and therefore, they CANNOT enter the nucleus and promote the cytokine synthesis Tacrolimus ( Prograf )-exerts its immunosuppressive effect in the same manner as cyclosporine, except it binds to a different immunophilin in the T-Cell lowers the risk of organ rejection!!!!! Selective Cytokine production inhibitor MOA - Ans:-They both enter the cell....form complexes within the cell that ultimately inhibit the production of cytokines...specifically Interleukin-2 ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 3/53 Cold versus Flu onset symptoms - Ans:-Flu-Sudden chills, severe cough, aches,fatigue, fever 3-4days, headache Cold- Gradual, sneezing sore throat common, rarely get a fever ,headache or chills Viral Neuraminidase - Ans:-an enzyme found on the surface of influenza viruses that enables the virus to be released from the host cell after replication Neraminidase inhibitors - Ans:-Oseltamivir ( Tamiflu) Zanamivir ( Relenza) MOA- Both prevent new viral particles from being released by the infected host cell by serving as a competitive inhibitor of the enzyme, nucleoside analog reverse transcriptase inhibitors - Ans:-It is an ANALOG or 'FAULTY VERSION' of DNA building blocks which is wrongly used by reverse transcriptase to convert RNA to DNA.When the reverse transcriptase uses these faulty building blocks, the new DNA cannot be built correctly, and new viral cells are prevented from being produced. Inhibits both Hepatitis B Virus and (in a lower doses) HIV Virus Reverse Transcriptase which is used by the viruses in their replication process. ( note exclusion of Hepatitis C Virus) NARTI drugs - Ans:-Tenofovir ( Viread) - for CHB Lamivudine( Epivir )- for CHB ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 4/53 excludes Hep C Interferon free antiviral drugs - Ans:-Viekira Pak-Ombitasvir - is a NS5A inhibitor with potent pangenotypic picomolar antiviral activity. ( a zinc-binding and proline-rich hydrophilic phosphoprotein that plays a key role in Hepatitis C virus RNA replication) Paritaprevir - is an inhibitor of the NS3/4A serine protease. (The NS3/4A serine protease is required for self-cleavage during viral replication, but may also inhibit activation of interferon signalling pathways in infected cells ) Dasabuvir - non-nucleoside NS5B polymerase inhibitor. ( has the key function of replicating the HCV's viral RNA ) Sofosbuvir - ( Solvadi ) Ledipasvir + Sofosbuvir ( Harvoni ) Simeprevir ( Olysio) Daclatasvir ( Daklinza ) 90% cure rate ©GRACEAMELIA 2024/2025 ACADEMIC YEAR. ALL RIGHTS RESERVED FIRST PUBLISH OCTOBER 2024 Page 5/53 no bone marrow suppression Zostavax - Ans:-a live vaccine that has been shown to reduce the incidence of herpes zoster (known as shingles) by 51.3% in a study of 38,000 adults aged 60 and older who received the vaccine shingles (herpes zoster) - Ans:-painful, blistering skin rash due to the varicella-zoster virus, the virus that causes chickenpox; the virus remains inactive (becomes dormant) in certain nerves in the body. Shingles occurs after the virus becomes active